Minimally invasive robotic surgery helps tonsil cancer patient avoid aggressive treatment

David Chan, MD, and tonsil cancer patient Stephen Polega
Otolaryngologist David Chan, MD, left, diagnosed Stephen Polega with early-stage tonsil cancer. Polega later received transoral robotic surgery at UChicago Medicine, and is cancer free today.

For Manteno resident Stephen Polega, an exam for sleep apnea at UChicago Medicine Ingalls Memorial led to the surprising discovery of early-stage tonsil cancer. Today he’s cancer-free thanks to minimally invasive robotic surgery and a network of collaborating physicians at the University of Chicago Medicine.

Polega’s primary care physician referred the 61-year-old to UChicago Medicine Medical Group otolaryngologist (ENT) David Chan, MD, after a sleep study showed the Army veteran had developed sleep apnea.

Polega saw Chan at UChicago Medicine at Ingalls - Flossmoor in late 2019, expecting to be given a continuous positive airway pressure (CPAP) machine for easier breathing at night.

“Dr. Chan looked in my throat and asked if I had been sick recently. I had no sore throat or cold, but my throat was red and inflamed,” Polega said.

Chan did a biopsy of Polega’s tonsils after a round of antibiotics didn’t reduce the redness and swelling. Tonsils, which are two oval-shaped pads in the back of the mouth, are part of the body's germ-fighting immune system.

In December 2019, Polega found out the biopsy’s results: he had a small malignant nodule on his left tonsil.

“My wife and I were floored,” Polega said. “We thought ‘What do you mean cancer?’ I had no symptoms.”

Nationwide, according to the American Cancer Society, an estimated 54,010 adults (38,800 men and 15,210 women) will be diagnosed with oral and oropharyngeal cancer in 2021. Of those cancers, tonsil cancer is the most common.

Symptoms typically include:

  • Difficulty swallowing
  • A sensation that something is caught in the back of your throat
  • Swelling and pain in the neck
  • Earache
  • Jaw stiffness

Since his cancer was in stage one, Polega was a good candidate for a type of minimally invasive robotic surgery called Transoral Robotic Surgery (TORS), which would remove both of his tonsils and several lymph nodes in his neck. The early diagnosis also meant Polega could avoid more invasive and harsher cancer treatments that many tonsil cancer patients need.

Traditionally when a patient has tonsil or tongue cancer, surgery involves opening the jaw or making an incision through the neck. But TORS allows us to do this through the mouth.

“Tonsil cancer is usually found in much later stages,” said Chan, who specializes in head and neck cancer surgery. “By the time patients begin experiencing symptoms, they’re often not good candidates for surgery. Instead, they’ll need more aggressive treatment like chemotherapy and radiation because their disease has progressed so far.”

Chan quickly involved Zhen Gooi, MD, Director of Robotic Head and Neck Surgery and Co-director of Head and Neck Surgical Oncology at UChicago Medicine.

“Traditionally when a patient has tonsil or tongue cancer, surgery involves opening the jaw or making an incision through the neck,” said Gooi. “But TORS allows us to do this through the mouth.”

During TORS, Gooi and other surgeons use robotic arms and high-resolution cameras to precisely work in small, difficult-to-reach areas. The procedure greatly reduces recovery time and risk of complications compared to traditional methods.

Polega said hospital staff and physicians thoroughly explained his care plan, and he felt confident in their expert approach. He underwent surgery at UChicago Medicine’s Hyde Park campus in January 2020 and spent 12 days in the hospital recovering.

“For Dr. Chan to see something and say ‘Hey, this isn’t right’ is just incredible,” Polega said. “I tell you, things could be a lot different. I give him and Dr. Gooi all the credit in the world.”

Polega has been cancer-free since the surgery. Today he is enjoying life as a proud father of two sons who followed his and his wife’s footsteps by joining the U.S. Army.

David Chan, MD, is a UChicago Medicine Medical Group provider. UChicago Medicine Medical Group is comprised of UCM Care Network Medical Group, Inc. and Primary Healthcare Associates, S.C. UChicago Medicine Medical Group providers are not employees or agents of The University of Chicago Medical Center, The University of Chicago, UChicago Medicine at Ingalls - Flossmoor, or UChicago Medicine Ingalls Memorial.

Zhen Gooi, MD, is a UChicago Faculty Physician. UChicago Faculty Physicians hold faculty positions with the University of Chicago and provide care for patients on the academic health system’s main campus in Hyde Park and in care centers throughout the Chicago region.

David Chan, MD

David Chan, MD

David Chan, MD, specializes in the care of patients with disorders of the head and neck. His clinical interest encompasses the full range of ear, nose and throat disorders with a special interest in advanced benign and malignant tumors of the head and neck.

View Dr. Chan's profile
Zhen Gooi, MD

Zhen Gooi, MD

Zhen Gooi, MD, specializes in the care of patients with benign and malignant head and neck tumors. His clinical interests are microvascular (free flap) reconstruction of the head and neck, and transoral robotic surgery, a minimally invasive approach for select head and neck tumors that avoids the need for traditional neck, jaw and throat incisions.

View Dr. Gooi's physician profile